Please Note: Fairhaven Christian Retirement Center is required by the Illinois Department of Public Health (IDPH) to conduct
fingerprint background checks on applicants to whom an offer has been made. If applicable, after an offer has been made, applicants will be required to complete a form on which they must indicate if they have been convicted of a crime other than a misdemeanor. Fairhaven may be bound by IDPH to withdraw the job offer dependent on background check results. Employment Experience
List your MOST RECENT employer first.
Employment Experience (continued)
Explain any gaps in your employment, other than those due to personal illness, injury or disability
Who do know that currently works here or has worked here? Educational Background
Special Training or Skills
Languages, medical training, certificates, etc. that might be of benefit in the job for which you are applying
full names and telephone numbers of three business/work references who are not related to you. If business/work references are not available, list three school or personal references who are not related to you.
State any additional work-related information you feel may be helpful to us in considering your application for this position
Conditions of Employment if you are selected for a position – please read carefully before signing
By signing this application, I am certifying that the information provided is true, accurate and complete to the best of my knowledge. I understand that, if employed, falsified information on or omission from this application will be grounds for dismissal.
By signing this document, I am authorizing the investigation of all information contained herein. This includes checking with schools, references and the employers listed on this application to confirm and verify its accuracy. I further agree to hold all respondents to these inquiries harmless with respect to any information given about me. I hereby release Fairhaven from any/all liability of whatever kind and nature which, at any time, could result from obtaining and investigating this information and utilizing it to make an employment decision.
I agree, if hired, to engage in no outside activity which would involve a material conflict of interest with, or which could reflect adversely on Fairhaven and that dismissal could result from these activities.
If employed, I agree to hold in confidence any and all information concerning Fairhaven and its residents which may become known to me, or dismissal may result.
If employed, I agree to conform to all employment policies of Fairhaven, or dismissal could result.
If employed, I understand that Fairhaven is an “at will employer” and that I can quit or have my employment terminated anytime with or without notice and with or without cause.
I understand that permanent employment or employment for a specific term cannot be guaranteed or promised in the absence of a specific written contract of employment between me and Fairhaven senior management. I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract.
I understand that a criminal background check including fingerprinting will be conducted and the results approved by the Illinois Department of Public Health before I can be hired and begin working at Fairhaven.
I understand that a physical examination to establish “fit for duty” including a drug test must be performed with results approved by Fairhaven’s contracted examination facility before I can be hired.